Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Thursday, December 13, 2007

Ejumuhkayshun

I had my last class of the semester last night, which means I'm not quite out of the woods -- I still have to read the final projects and turn in the grades -- but this is always the occasion when I reflect on the educational enterprise.

Like most college professors, I have essentially no formal training in pedagogy. I've had to figure it out as I go along, and it hasn't been easy. One of the hardest lessons had to do with the recognition that they don't necessarily start out believing that I'm on their side, and some of them don't want me to be on their side in quite the way that I actually am. In other words, we may just have a different idea of what this graduate degree thing is all about.

Education in our society has at least two different functions which coexist uneasily. One is to help people develop their potential -- to learn facts and skills, such as critical thinking, intellectual creativity, writing, and skills specific to a profession. That's how I'm on their side. But the other function is sort people into categories of prestige and income, and the awful truth is, that's why a lot of people, maybe most of them, go to college and graduate school. If they don't learn the facts and skills I'm there to teach them, I will stand in the way of the magic label that will make them prosperous and respectable.

When this happens -- and I'm very happy to say it did not happen this semester -- they generally ascribe the cause to my arrogance, cruelty and elitism. The true cause is never their innate lack of ability -- by the time they get to me, it's generally the case that they have already established their ability to do school work. A few have slipped through with basic skill deficits -- you can get into medical school without being able to write an intelligible sentence -- but that won't stop them from passing my course if they'll acknowledge the problem and work with me to start fixing it. I don't judge you on where you came in, I judge you on how far you traveled.

No, the true cause of their failure is misunderstanding the purpose of the enterprise. People have experienced education as a process of judging, and sorting, and labeling. It's been adversarial, students against the system. It's left a lot of people as wreckage by the roadside. A lot of people perceive the purpose of attending college as getting a college degree, and that's why cheating is rampant. It's also why students have highly developed skills for wheedling, threatening and otherwise extracting grades from instructors by means other than working hard and conscientiously on their assignments.

I'm not involved in elementary or high school education but I can't believe that this obsessive focus on standardized testing is doing anything but making education less and less about developing human potential and more and more about sorting people into castes. Of course, there are benign and necessary reasons for sorting. People's aptitudes differ and we need some method of getting people tracked into careers that make sense for them. If we assign people to jobs they don't have the skills, talent, or personality traits to do well, we invite disaster, whether we're talking about a surgeon or an electrician.

The challenge is to engage positively and supportively with every child, adolescent and adult who is in the role of student, whatever that means for that person. But we really don't do that. We create winners and losers. We hurt people. We manufacture injustice.